Even those people with the proverbial cast-iron stom­ach get gut-wrenching gastritis now and then. Whether it’s mild or more severe, your stomach is quick to let you know something strange is going on down there.

Gastritis attacks can surprise you suddenly or they may develop as a chronic condition more slowly over time. Many different things can trigger gastritis, includ­ing a bacterial or viral infection, surgery, serious injuries, anxiety, overwork, spicy foods, alcohol, and even certain drugs. The drugs most often responsible for a stomach upset by gastritis include aspirin, ibuprofen, and other non-steroidal anti-inflammatory drugs (NSAIDs), as well as anticancer drugs.

Sometimes, it’s simply a matter of age. As you grow older, your stomach lining deteriorates, making you more susceptible to irritants or infections that leave your stomach swollen and upset.

Fortunately, there are a number of ways to control your gastritis.

Limit your food intake. Restrict your diet to liq­uids the first day of the attack. Frequently drink small amounts of milk, water, or weak tea.

Relieve pain with acetaminophen instead of aspirin, which will just worsen your stomach irri­tation. Sometimes, gastritis may even cause chest pain. To relieve your discomfort, drink 16 ounces of lukewarm water slowly and continuously. However, if your chest pain spreads to your shoulder, neck, or arms or you feel faint or short of breath, you may be having a heart attack and should get medical help immediately.

Begin eating after 24 hours. Choose only foods you know you can tolerate. Avoid foods, especially spicy ones, that you know upset your stomach. If you can’t really pinpoint which foods cause you problems, keep a food diary for several days to see if you notice any patterns.

Eat small meals on a regular schedule. You’re less likely to suffer a gastritis attack if you eat six small meals a day instead of three large meals.

Avoid alcohol, caffeine and smoking. All of these habits will only worsen gastritis.

Discuss your medicines with your doctor. If you are taking prescription NSAIDs, certain anticancer drugs, or other medicines you suspect may be contributing to your gastritis, ask your doctor about switching to a different drug. If that’s not possible, ask if you could take your medicine with food, which may reduce its irritating effect on your stomach.

Generally, repeat attacks of gastritis are caused by smoking, overeating, or drinking too much. You should talk to your doctor if you are sure none of those habits are contributing to the problem, especially if you see no improvement after trying the above measures.